The PREDICT (Precision Diagnostics in Inflammatory Bowel Disease, Cellular Therapy, and Transplantation) trial aims to identify how the disease-fighting T cells of the immune system are disrupted in pediatric patients with inflammatory bowel disease (IBD) and pediatric patients who undergo bone marrow transplantation and who develop graft-versus-host disease (GVHD) of the gastrointestinal tract. It also aims to deeply interrogate immunologic outcomes after CAR-T and other immunotherapies.
Both IBD and GVHD are related to the immune system and both IBD patients and a subset of patients who have GVHD experience similar gastrointestinal symptoms, including vomiting, diarrhea and the inability to absorb nutrients. We will accomplish this by sequencing and looking for gene expression signatures – patterns of genetic alterations unique to the patient’s medical condition – in the T cells of 100 patients with IBD and 250 patients who have had bone marrow transplants. We look at both single cell transcriptomic data (scRNAseq) and flow cytometric data from gastrointestinal samples and blood. In addition to host immunity, we also plan to research the microbiota signatures of each of these diseases. Ultimately, we hope to uncover information that can enable molecular diagnoses of these disorders, as well as identify targeted therapies to better treat them.
In the cellular therapy arm of PREDICT we perform flow cytometric, single cell RNAseq and cytokine analysis to determine predictors of success and failure with immunotherapy techniques.